Pediatric ophthalmologist, optometrist presence is lacking in much of the United States

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A study observed geographic disparities in access to pediatric eye care providers for a majority of U.S. counties, highlighting an unmet need for this patient population.

The cross-sectional study used 4 public databases to identify pediatric optometrists and ophthalmologists in the United States in April 2023: 586 pediatric optometrists and 1,060 pediatric ophthalmologists.

Across the 3,000 U.S. counties studied, just 6.5% had at least 1 pediatric optometrist, while 9.7% had at least 1 pediatric ophthalmologist, with substantial geographic overlap between the two (odds ratio, 12.7; 95% CI, 9.4-17.4; P<.001). Over 95% (96.4%) of counties without pediatric ophthalmologists also lacked pediatric optometrists.

There were more pediatric ophthalmologists per million people (3.3) compared with pediatric optometrists per million people (2.5) across all states (difference, 0.8; 95% CI, 0.0-1.9; P=.047).

Socioeconomic factors also impacted access to these pediatric providers. Compared with counties that had pediatric optometrists, those with pediatric ophthalmologists had higher:

  • Mean household income ($76,126.87 vs $68,681.77; difference, –$7445.10; 95% CI, $2,519.51-$12,370.69; P=.003)
  • Mean population with a bachelor’s degree (79,016 vs 23,076; difference, –55,940; 95% CI, –73,035 to –38,845; P<.001)

Compared with counties with these practitioners, those with neither specialist type available had the lowest:

  • Mean household income ($57,714.03 vs $78,388.67; difference, –$20 675.00; 95% CI, –$21,550.90 to –$19,799.10; P<.001)
  • Mean population with a bachelor’s degree (5,113 vs 167,015; difference, –161,902; 95% CI, –170,388.9 to –153,415.1; P<.001)

The study “underscores the urgency of augmenting practitioner support in underserved areas,” the authors concluded.


Siegler NE, Walsh HL, Cavuoto KM. Access to pediatric eye care by practitioner type, geographic distribution, and US population demographics. JAMA Ophthalmol. 2024:e240612. doi:10.1001/jamaophthalmol.2024.0612